Clinical Features of Patients Infected With Coronavirus Disease 2019 With Elevated Liver Biochemistries: A Multicenter, Retrospective Study.
Adolescent
Adult
Aged
Aged, 80 and over
Alanine Transaminase
/ blood
Aspartate Aminotransferases
/ blood
Bilirubin
/ blood
COVID-19
/ blood
China
/ epidemiology
Comorbidity
Female
Humans
Liver
/ physiopathology
Liver Diseases
/ blood
Male
Middle Aged
Prognosis
Retrospective Studies
SARS-CoV-2
Severity of Illness Index
Young Adult
Journal
Hepatology (Baltimore, Md.)
ISSN: 1527-3350
Titre abrégé: Hepatology
Pays: United States
ID NLM: 8302946
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
revised:
24
06
2020
received:
14
04
2020
accepted:
25
06
2020
pubmed:
1
7
2020
medline:
22
4
2021
entrez:
1
7
2020
Statut:
ppublish
Résumé
In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. Although it has been reported that some patients with COVID-19 showed elevated liver biochemistries, there are few studies regarding the clinical features and prognosis of these patients. In this multicenter, retrospective study, we collected data on laboratory-confirmed patients with COVID-19 from three hospitals in Wuhan, China, who died or were discharged between February 1, 2020, and February 20, 2020. Data on demographics, comorbidities, clinical symptoms, laboratory examinations on admission, complications, treatment, and outcome were collected. A total of 482 patients were enrolled in this study. Of those, 142 (29.5%) patients showed abnormal liver biochemistries on admission, and patients with elevated alanine aminotransferase, aspartate aminotransferase (AST), and total bilirubin (TBIL) accounted for 67.6%, 69.0%, and 16.2%, respectively. Those with abnormal liver biochemistries showed higher percentages of severe cases and comorbidities and were more likely to have dyspnea, chest distress or pain, and increased hemoglobin (Hb) on admission. Higher rates of complications and mortality and worse recovery when discharged were observed in patients with abnormal AST or TBIL. Multivariable regression analysis showed that chest distress or pain (odds ratio [OR], 1.765; P = 0.018), dyspnea (OR, 2.495; P = 0.001), elevated C-reactive protein level (OR, 1.007; P = 0.008), elevated white blood count (OR, 1.139; P = 0.013), and elevated Hb concentration (OR, 1.024; P = 0.001) were independent factors associated with elevated liver biochemistries in patients with COVID-19. Elevated liver biochemistries were common in patients with COVID-19. Patients with hypoxia or severe inflammation are more likely to experience increased liver biochemistries on admission. Those with abnormal AST or TBIL on admission are more likely to suffer from severe complications and death.
Sections du résumé
BACKGROUND AND AIMS
In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. Although it has been reported that some patients with COVID-19 showed elevated liver biochemistries, there are few studies regarding the clinical features and prognosis of these patients.
APPROACH AND RESULTS
In this multicenter, retrospective study, we collected data on laboratory-confirmed patients with COVID-19 from three hospitals in Wuhan, China, who died or were discharged between February 1, 2020, and February 20, 2020. Data on demographics, comorbidities, clinical symptoms, laboratory examinations on admission, complications, treatment, and outcome were collected. A total of 482 patients were enrolled in this study. Of those, 142 (29.5%) patients showed abnormal liver biochemistries on admission, and patients with elevated alanine aminotransferase, aspartate aminotransferase (AST), and total bilirubin (TBIL) accounted for 67.6%, 69.0%, and 16.2%, respectively. Those with abnormal liver biochemistries showed higher percentages of severe cases and comorbidities and were more likely to have dyspnea, chest distress or pain, and increased hemoglobin (Hb) on admission. Higher rates of complications and mortality and worse recovery when discharged were observed in patients with abnormal AST or TBIL. Multivariable regression analysis showed that chest distress or pain (odds ratio [OR], 1.765; P = 0.018), dyspnea (OR, 2.495; P = 0.001), elevated C-reactive protein level (OR, 1.007; P = 0.008), elevated white blood count (OR, 1.139; P = 0.013), and elevated Hb concentration (OR, 1.024; P = 0.001) were independent factors associated with elevated liver biochemistries in patients with COVID-19.
CONCLUSIONS
Elevated liver biochemistries were common in patients with COVID-19. Patients with hypoxia or severe inflammation are more likely to experience increased liver biochemistries on admission. Those with abnormal AST or TBIL on admission are more likely to suffer from severe complications and death.
Identifiants
pubmed: 32602604
doi: 10.1002/hep.31446
pmc: PMC7361581
doi:
Substances chimiques
Aspartate Aminotransferases
EC 2.6.1.1
Alanine Transaminase
EC 2.6.1.2
Bilirubin
RFM9X3LJ49
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1509-1520Subventions
Organisme : National Natural Science Foundation of China
ID : 81570501
Organisme : National Natural Science Foundation of China
ID : 81770554
Organisme : National Natural Science Foundation of China
ID : 81772607
Organisme : National Natural Science Foundation of China
ID : 81974383
Organisme : Natural Scientific and Technology Program
ID : 2018ZX10302204-002-003
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 by the American Association for the Study of Liver Diseases.
Références
Lancet Respir Med. 2020 Apr;8(4):420-422
pubmed: 32085846
Respirology. 2006 Nov;11(6):715-22
pubmed: 17052299
Am J Respir Crit Care Med. 2020 Jun 1;201(11):1380-1388
pubmed: 32275452
Acta Med Scand. 1978;203(3):167-74
pubmed: 636912
Signal Transduct Target Ther. 2020 Mar 27;5(1):33
pubmed: 32296069
J Physiol. 1977 Jul;269(1):53-76
pubmed: 894569
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
Front Public Health. 2020 Apr 29;8:152
pubmed: 32411652
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
JAMA Cardiol. 2020 Jul 1;5(7):811-818
pubmed: 32219356
Am J Respir Crit Care Med. 2020 Sep 1;202(5):756-759
pubmed: 32663409
J Med Virol. 2020 Jun;92(6):589-594
pubmed: 32100876
J Infect Dis. 2014 May 1;209(9):1331-42
pubmed: 24065148
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
N Engl J Med. 2003 May 15;348(20):1986-94
pubmed: 12682352
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Front Immunol. 2020 May 01;11:827
pubmed: 32425950
Clin Gastroenterol Hepatol. 2020 Jun;18(7):1561-1566
pubmed: 32283325
Circulation. 2020 May 19;141(20):1648-1655
pubmed: 32200663
Lancet Respir Med. 2020 May;8(5):475-481
pubmed: 32105632
Science. 2020 Apr 24;368(6489):356-360
pubmed: 32327580